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Atrial fibrillation (known as AFIB) is a known risk factor for dementia and other types of cognitive decline. This risk is higher in seniors with AFIB, in part due to the increased risk of a stroke in atrial fibrillation. The following is useful information for families with seniors living with AFIB.
What is AFIB?
A normal heart beats at a steady pace. The well-functioning heart muscle contracts and relaxes to a regular beat. However, in patients with atrial fibrillation, the atria (the upper chambers of the heart) beat irregularly. This quiver prevents the heart from efficiently moving blood into the ventricles.
An irregular heartbeat is known as an arrhythmia. Quivers in heartbeats can lead to blood clots, strokes, heart failure and other types of heart-related ailments. A blood clot that enters the bloodstream and lodges in an artery leading up to the brain could result in a stroke.
In fact, 15 to 20 percent of stroke patients have an arrhythmia. Left untreated, atrial fibrillation is associated with a five-fold increase in a patient experiencing a stroke as well as doubles the senior’s risk for heart-related deaths. Most seniors, however, are unaware of the severity of AFIB.
AFIB symptoms vary. Some people experience a flip flop of the heart. Or, upon physical exertion, the heart may feel like it skips a beat. Individuals may feel lightheaded, nauseated and weak. A rapid heartbeat might leave a person gasping for air. Others may have no symptoms at all.
Nearly three million people in the US live with AFIB. Studies done in 2009 reveal that only 33 percent of AFIB patients consider it to be a serious condition. Of those questioned, less than half believe they have a higher risk for stroke, heart-related illnesses or death.
Why do AFIB patients have an increased risk for dementia?
Observational studies conclude that people with AFIB have a consistently higher rate of dementia. AFIB is known to cause these patients to have a higher risk for stroke. But additional associated contributors can cause people with AFIB to be at a greater risk for cognitive decline.
These additional contributors include mechanisms, such as silent cerebral infarcts (a stroke, which occurs when clusters of brain cells do not receive enough blood and subsequently die), microbleeds (small, chronic brain hemorrhages) and cerebral hypoperfusion (inadequate blood flow to the brain).
Are AFIB patients without a stroke history affected?
Between 2014 and 2017, an observational study of thousands of AFIB patients over the age of 65 was conducted. Brain MRIs were done and the results were unexpected. Almost 1500 of these AFIB patients reported they had never experienced a stroke or mini-stroke.
Despite the strong links between AFIB, stroke and the resulting increased risk for dementia, over 40 percent of the AFIB patients in the aforementioned study had no history of strokes or mini-strokes. Yet, these patients, after having undergone brain MRIs, showed previously unknown silent brain damage.
These unrecognized brain lesions are a form of brain damage; and, brain damage can lead to dementia and other types of cognitive decline. It is clear that even in AFIB patients who do not have a history of strokes, dementia and cognitive decline can set in.
How does AFIB affect cognitive functions?
Studies show that patients who are diagnosed with AFIB (but who do not have a stroke history) perform worse on tests that evaluate memory, executive functioning and learning in comparison to patients who do not have AFIB. It is also shown that AFIB is linked with impaired global cognitive functioning.
Community-based studies, such as the Cardiovascular Health Study, show that in patients who develop AFIB, cognitive functions decline faster. Decline is also more rapid in not only executive function but verbal fluency. As individuals age, the impact of decline becomes stronger.
The presence of AFIB is also associated with other types of dementias, like Alzheimer’s disease. Patients with AFIB have a higher burden of cerebral microbleeds and are more likely to have a higher rate of silent cerebral infarcts. Consequently, cognitive decline progresses rapidly and dementia sets in.
What are the treatment options for AFIB?
Anticoagulants are often prescribed to treat patients living with AFIB. Anticoagulants are blood thinners that can help prevent blood clots or prevent a blocked vessel. Three types of blood thinners are available: anticoagulants, like warfarin; aspirin; and, fibrinolytics. Each medication has a specific role.
Currently, it is unclear whether or not anticoagulants are effective in reducing the risk for developing dementia or cognitive impairment. Some studies show a decrease in the risk of developing AFIB-related dementia or prevention of the condition in patients who take oral anticoagulants.
However, these studies are limited, and more research and randomized trials are needed to determine the efficacy of anticoagulant therapies in preventing or reducing the risk of developing AFIB-related dementias or other forms of cognitive decline in the older population.
Dementia progresses gradually and worsens over time. When a dementia diagnosis is made, it is important to start planning for the future. Your aging loved one will benefit from the in-home dementia care services provided by a dependable home care agency, like Assisting Hands Home Care.
Our dementia caregivers are specifically trained to compassionately handle the various symptoms of dementia. We use positive reinforcement to calm patients who are agitated. Our caregivers also engage in a variety of memory care exercises to stimulate their minds and slow memory loss.
As attentive memory care providers, Assisting Hands Home Care caregivers gently lead wandering dementia patients to a place of safety. We discreetly help with incontinence issues. Communication is handled with skill to ensure the patients understand messages while feeling respected.
Our home are services are nonmedical yet comprehensive. We provide daily help with all the activities of daily living, too. When your aging loved one needs memory care, choose Assisting Hands Home Care in Will and Kendall Counties and Plainfield, Illinois. We are dedicated to providing quality elder care.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988519/,https://www.cardiovascularbusiness.com/topics/heart-rhythm/40-afib-patients-have-silent-brain-damage,https://www.heart.org/en/health-topics/atrial-fibrillation/what-is-atrial-fibrillation-afib-or-af,https://www.webmd.com/brain/qa/what-is-cerebral-infarction,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075149/,https://me-pedia.org/wiki/Cerebral_hypoperfusion,https://pubmed.ncbi.nlm.nih.gov/30391408/
